Expanding Multiple Procedure Payment Reduction (MPPR) Policy

Medicare has a longstanding policy to reduce payment by 50 percent for the second andsubsequent surgical procedures furnished to the same patient by the same physician on thesame day. Effective January 1, 1995, the MPPR policy, with the same percentage reduction,was extended to nuclear medicine diagnostic procedures. Under the CY 2006 PFS, the MPPRpolicy was extended to the technical component (TC) of certain diagnostic imaging proceduresperformed on contiguous areas of the body in a single session and effective January 1, 2011 theimaging MPPR applies regardless of code family. MPPR was also extended to therapy services2011. And for 2012, specifically, CMS proposes to expand the 50 percent payment reductioncurrently applied to the TC to apply also to the PC of the second and subsequent advancedimaging services furnished in the same session.

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